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No abstract available.
Commerce* ; Mining*

OBJECTIVES: Although sonography-guided core needle biopsy is a highly targeted method, there is a possibility of an invasive component after surgical excision of ductal carcinoma in situ (DCIS) of the breast. This study was performed to develop and validate nomograms to predict the postoperative invasive component in DCIS at core needle biopsy. METHODS: Two nomograms were developed using the data of previous meta-analysis and multivariate analysis. Nomograms were validated externally using the data of the authors' affiliation. The accuracy was validated by the expected-to-observed ratio and the Hosmer-Lemeshow goodness-of-fit test. Discrimination was validated by the area under the curve (AUC) of receiver operating characteristic (ROC) curve analysis. RESULTS: The nomogram using the meta-analysis study data was developed at http://dcis-m.surgery.kr.pe/, and the nomogram using the multivariate analysis study data was developed at http://dcis-k.surgery.kr.pe/. The Hosmer-Lemeshow goodness-of-fit test showed that the nomogram using multivariate analysis data (p = 0.131) was better calibrated than that using meta-analysis data (p < 0.001). ROC curve analysis showed statistically significant power of discrimination in both nomograms (AUC = 0.776, 0.751). CONCLUSIONS: Both nomograms showed statistically significant discriminatory power, but the nomogram using the data of multivariate analysis was simpler and more reliable. These would be useful for the prediction of invasive cancer and the need for sentinel node biopsy in DCIS at core needle biopsy.
Biopsy* ; Biopsy, Large-Core Needle ; Breast* ; Carcinoma, Intraductal, Noninfiltrating* ; Discrimination (Psychology) ; Internet ; Multivariate Analysis ; Needles* ; Nomograms* ; ROC Curve

OBJECTIVES: Health Avatar Beans was for the management of chronic kidney disease and end-stage renal disease (ESRD). This article is about the DialysisNet system in Health Avatar Beans for the seamless management of ESRD based on the personal health record. METHODS: For hemodialysis data modeling, we identified common data elements for hemodialysis information (CDEHI). We used ASTM continuity of care record (CCR) and ISO/IEC 11179 for the compliance method with a standard model for the CDEHI. According to the contents of the ASTM CCR, we mapped the CDHEI to the contents and created the metadata from that. It was transformed and parsed into the database and verified according to the ASTM CCR/XML schema definition (XSD). DialysisNet was created as an iPad application. The contents of the CDEHI were categorized for effective management. For the evaluation of information transfer, we used CarePlatform, which was developed for data access. The metadata of CDEHI in DialysisNet was exchanged by the CarePlatform with semantic interoperability. RESULTS: The CDEHI was separated into a content list for individual patient data, a contents list for hemodialysis center data, consultation and transfer form, and clinical decision support data. After matching to the CCR, the CDEHI was transformed to metadata, and it was transformed to XML and proven according to the ASTM CCR/XSD. DialysisNet has specific consideration of visualization, graphics, images, statistics, and database. CONCLUSIONS: We created the DialysisNet application, which can integrate and manage data sources for hemodialysis information based on CCR standards.
Chronic Disease ; Compliance ; Continuity of Patient Care* ; Fabaceae ; Health Information Management ; Health Records, Personal ; Humans ; Information Storage and Retrieval* ; Kidney Failure, Chronic ; Renal Dialysis* ; Renal Insufficiency, Chronic ; Semantics

OBJECTIVES: The purpose of this study was to identify the effects of hospitals' innovativeness on outsourcing decision-making regarding four information system (IS) functions, namely, software programs, network maintenance, hardware systems, and PC/printer maintenance. METHODS: Using the 2011 roster of the Korean Hospital Association, this study selected 311 general hospitals as a study population. After identifying the managers who were in charge of outsourcing, this study administered questionnaires. A total of 103 hospitals responded. RESULTS: Of the responding hospitals, 55.34% outsourced at least one IS function, whereas 88.35% outsourced at least one managerial function. IS outsourcing was motivated by the need for outside experts, but other managerial functions were outsourced for cost savings. Innovative and early adopter hospitals were 4.52 and 4.91 times more likely to outsource IS functions related with work processes (i.e., software and network maintenance) than early and late majority hospitals, respectively. IT outsourcing effectiveness significantly influenced the outsourcing decisions regarding four IS functions. Hospitals that had perceived more risks of outsourcing significantly preferred non-outsourcing on their hardware systems, but the risks of outsourcing were not significant for outsourcing decisions regarding the other IS functions. Hospitals' innovativeness also significantly explained the quantity of innovation adoptions. Innovative and early adopter hospitals did more outsourcing than early and late majority hospitals. CONCLUSIONS: Hospitals' innovativeness influences decision-making regarding outsourcing. Innovative hospitals are more likely to outsource their work-process-related IS functions. Thus, organizational traits, especially hospitals' innovativeness, should be considered as a key success factor for IS management.
Cost Savings ; Hospitals, General ; Information Systems* ; Organizational Innovation ; Outsourced Services* ; Surveys and Questionnaires

OBJECTIVES: The purposes of this study were to identify the factors that affect the health-related quality of life (HRQoL) of the elderly with chronic diseases and to subsequently develop from such factors a prediction model to help identify HRQoL risk groups that require intervention. METHODS: We analyzed a set of secondary data regarding 716 individuals extracted from the Korea National Health and Nutrition Examination Survey from 2008 to 2010. The statistical package of SPSS and MATLAB were used for data analysis and development of the prediction model. The algorithms used in the study were the following: stepwise logistic regression (SLR) analysis and machine learning (ML) techniques, such as decision tree, random forest, and support vector machine methods. RESULTS: Five factors with statistical significance were identified for HRQoL in the elderly with chronic diseases: 'monthly income', 'diagnosis of chronic disease', 'depression', 'discomfort', and 'perceived health status.' The SLR analysis showed the best performance with accuracy = 0.93 and F-score = 0.49. The results of this study provide essential materials that will help formulate personalized health management strategies and develop interventions programs towards the improvement of the HRQoL for elderly people with chronic diseases. CONCLUSIONS: Our study is, to our best knowledge, the first attempt to identify the influencing factors and to apply prediction models for the HRQoL of the elderly with chronic diseases by using ML techniques as an alternative and complement to the traditional statistical approaches.
Aged* ; Chronic Disease* ; Complement System Proteins ; Decision Trees ; Humans ; Korea ; Logistic Models ; Machine Learning* ; Nutrition Surveys ; Quality of Life* ; Statistics as Topic ; Support Vector Machine

OBJECTIVES: This study was conducted to develop a smartphone application (app) as an educational learning instrument for coronary artery disease (CAD) patients and to assess the users' level of satisfaction. METHODS: This methodological research involves elicited learning content for CAD patients to develop a learning instrument using the smartphone app. The app was developed according to the steps of Assessment, Design, Development, Implementation, and Evaluation, which is a systematic instructional design model. The levels of satisfaction with the developed smartphone app among 30 outpatients with CAD were assessed via a questionnaire during their visits to a cardiology outpatient department. RESULTS: A smartphone app 'Strong Heart' was developed through reviewing the literature associated with education for CAD patients under professional supervision and searching for medical smartphone apps that are already available. The learning contents include six main sections containing essential learning issues in managing CAD and additional information to attract the user's attention, such as patient cases and quizzes. After modification with feedback from experts, the app was finally developed and evaluated by patients who reported that they were satisfied with the usefulness of the app. CONCLUSIONS: The developed smartphone app is available on both the iPhone App Store and the Android Play Store. Patients with CAD may utilize the app for supporting educational material without limitations of time and space.
Cardiology ; Coronary Artery Disease* ; Education ; Educational Technology ; Humans ; Learning ; Mobile Applications ; Organization and Administration ; Outpatients ; Patient Education as Topic ; Surveys and Questionnaires

OBJECTIVES: Due to the unique characteristics of clinical data, clinical data warehouses (CDWs) have not been successful so far. Specifically, the use of CDWs for biomedical research has been relatively unsuccessful thus far. The characteristics necessary for the successful implementation and operation of a CDW for biomedical research have not clearly defined yet. METHODS: Three examples of CDWs were reviewed: a multipurpose CDW in a hospital, a CDW for independent multi-institutional research, and a CDW for research use in an institution. After reviewing the three CDW examples, we propose some key characteristics needed in a CDW for biomedical research. RESULTS: A CDW for research should include an honest broker system and an Institutional Review Board approval interface to comply with governmental regulations. It should also include a simple query interface, an anonymized data review tool, and a data extraction tool. Also, it should be a biomedical research platform for data repository use as well as data analysis. CONCLUSIONS: The proposed characteristics desired in a CDW may have limited transfer value to organizations in other countries. However, these analysis results are still valid in Korea, and we have developed clinical research data warehouse based on these desiderata.
Anonyms and Pseudonyms ; Ethics Committees, Research ; Ethics, Research ; Information Storage and Retrieval ; Korea ; Privacy ; Research Design ; Social Control, Formal ; Statistics as Topic

No abstract available.
Delivery of Health Care*

OBJECTIVES: The Web-based integrated public healthcare information system (PHIS) of Korea was planned and developed from 2005 to 2010, and it is being used in 3,501 regional health organizations. This paper introduces and discusses development and performance of the system. METHODS: We reviewed and examined documents about the development process and performance of the newly integrated PHIS. The resources we analyzed the national plan for public healthcare, information strategy for PHIS, usage and performance reports of the system. RESULTS: The integrated PHIS included 19 functional business areas, 47 detailed health programs, and 48 inter-organizational tasks. The new PHIS improved the efficiency and effectiveness of the business process and inter-organizational business, and enhanced user satisfaction. Economic benefits were obtained from five categories: labor, health education and monitoring, clinical information management, administration and civil service, and system maintenance. The system was certified by a patent from the Korean Intellectual Property Office and accredited as an ISO 9001. It was also reviewed and received preliminary comments about its originality, advancement, and business applicability from the Patent Cooperation Treaty. It has been found to enhance the quality of policy decision-making about regional healthcare at the self-governing local government level. CONCLUSIONS: PHIS, a Web-based integrated system, has contributed to the improvement of regional healthcare services of Korea. However, when it comes to an appropriate evolution, the needs and changing environments of community-level healthcare service and IT infrastructure should be analyzed properly in advance.
Commerce ; Delivery of Health Care* ; Health Education ; Information Management ; Information Systems* ; Intellectual Property ; International Cooperation ; Korea* ; Local Government ; Public Health Informatics ; Systems Integration